scholarly journals Clinical effects of two-stage joint replacement on septic arthritic knee

2020 ◽  
Author(s):  
Ming Ni ◽  
Jun Fu ◽  
Tao Deng ◽  
Erlong Niu ◽  
Chi Xu ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Tibial Plateau ◽  
Recurrent Infection ◽  
Clinical Effects ◽  
Antibiotic Cement ◽  
Post Surgery ◽  
Significant Difference ◽  
Post Operation ◽  
Arthritic Knee

Abstract Objective: To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer. Methods: 23 patients (24 knee joints) treated with staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first-stage, thoroughly debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer was performed; After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement. Results: All patients finished follow-up and the mean follow-up time was 27.3 months (12-54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved post-operation (p<0.05). And there was no significant difference in post-surgery ROM (P=0.153) and the HSS score (P = 0.054) between the two groups. Conclusion: Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.

scholarly journals Clinical effects of staged joint replacement in patients with septic arthritic knee

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ming Ni ◽  
Jun Fu ◽  
Tao Deng ◽  
Erlong Niu ◽  
Chi Xu ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Tibial Plateau ◽  
Recurrent Infection ◽  
Clinical Effects ◽  
Antibiotic Cement ◽  
Post Surgery ◽  
Significant Difference ◽  
Thorough Debridement ◽  
Arthritic Knee

Abstract Objective To assess the clinical effect of staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer. Methods Twenty-three patients (24 knee joints) treated with a staged joint replacement for septic arthritis knee were retrospectively reviewed between March 2014 and April 2018. At the first stage, thorough debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer were performed. After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, the second-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement. Results All patients finished follow-up, and the mean follow-up time was 27.3 months (12–54 months). Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved postoperation (p < 0.05). And there was no significant difference in the post-surgery ROM (p = 0.153) and the HSS score (p = 0.054) between the two groups. Conclusion Staged joint replacement is an efficacious way for septic arthritic knees, whether tibial plateau spacer or antibiotic cement beads were used, which can effectively control infection and improve knee function.

scholarly journals Clinical effects of two-stage joint replacement on septic arthritic knee

2020 ◽  
Author(s):  
Ming Ni ◽  
Jun Fu ◽  
Tao Deng ◽  
Erlong Niu ◽  
Chi Xu ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Tibial Plateau ◽  
Recurrent Infection ◽  
Knee Joints ◽  
Clinical Effects ◽  
Two Stage ◽  
Antibiotic Cement ◽  
Significant Difference ◽  
Arthritic Knee

Abstract Objective: To assess the clinical effect of two staged joint replacement for the treatment of septic arthritic knee and the therapeutic differences between antibiotic cement beads and the tibial plateau spacer.Methods: 26 patients (27 knee joints) treated with spacer (antibiotic cement beads or the tibial plateau spacer) for septic arthritis knee were retrospectively reviewed between 2014 and 2018. At the first stage, thoroughly debridement and irrigation with self-made antibiotic cement beads or tibial plateau spacer was performed; After that, systemic antibiotic treatment was followed; when the infection was surely eliminated, Two-stage TKA was performed. Knee mobility (range of motion, abbreviated to ROM) and function (HSS scores system) were evaluated before surgery, in the interval period, and after joint replacement.Results: All patients finished follow-up and the follow-up time was 27.3 months (12-54 months). 23 patients (24 knee joints) completed the staged surgery as expected, 3 patients in the beads group gave up the second-stage operation after infection elimination. Each group has one patient replaced with a homotypic spacer, and all patients eventually cleared the infection. None of the patients had a recurrent infection. The mobility and HSS scores of the two groups were significantly improved post-operation (p<0.05). There was no significant difference in mobility between the two groups (p=0.153). The HSS score of the tibial plateau spacer group had a better trend of improvement after TKA (p= 0.054).Conclusion: Two-stage TKA is an efficacious way for septic arthritic knees, which can effectively control infection and improve knee function.

scholarly journals A Comparison of the Quality of Sleep between Pre and Post-Surgery Cervical Herniated Nucleus Pulposus Patients Utilizing the Anterior Discectomy Method

2017 ◽  
Vol 5 (7) ◽  
pp. 948-954
Author(s):  
Ridha Dharmajaya ◽  
Dina Keumala Sari ◽  
Ratna Akbari Ganie
Keyword(s):  
Sleep Quality ◽  
Nucleus Pulposus ◽  
Intervertebral Disk ◽  
Quality Of Sleep ◽  
Post Surgery ◽  
Anterior Discectomy ◽  
Significant Difference ◽  
Post Operation ◽  
Herniated Nucleus Pulposus

BACKGROUND: Herniated Nucleus Pulposus (HNP) is the prolapse of the intervertebral disk through a tear in the annulus fibrosus. This causes nerve root compression with clinical pain manifestation and affects the quality of sleep.AIM: The aim of this study was find out the comparison in the quality of sleep between before (pre) and after (post) surgery cervical HNP patients.METHODS: This study was a retrospective cohort study. Ninety patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) questionnaire. All data which has been computed were analysed with the McNemar test.RESULT: The outcome reveals that from 90 patient`s cervical HNP, 81 (90%) were 40 years old age group and 66 (73.3%) of them were women. The result showed that 66 (73.3%) patients have a bad sleep quality before surgery. Surgery has increased the quality of sleep after surgery 66 (73.3%) patients had good sleep quality. There was a significant difference in the quality of sleep pre and post operation (p = 0.001).CONCLUSION: There was a significant difference in the quality of sleep between pre and post operation cervical HNP patient utilising anterior discectomy methods.

CLINICAL AND RADIOLOGIC OUTCOMES OF TWO TYPES OF CAGES USED IN THE TREATMENT OF DEGENERATIVE LUMBAR DISEASES: NOVEL TITANIUM CAGES VERSUS PEEK CAGES

2020 ◽  
Vol 23 (01) ◽  
pp. 2050004
Author(s):  
Meng-Yin Yang ◽  
Hsin-Huan Chang ◽  
Shao-Ching Chao
Keyword(s):  
Transforaminal Lumbar Interbody Fusion ◽  
Neurological Status ◽  
Clinical Effects ◽  
Disc Disease ◽  
Degenerative Lumbar Diseases ◽  
Intervertebral Disc Height ◽  
Significant Difference ◽  
Vas Scores ◽  
Titanium Cages

Purpose: This study reports the clinical effects of [Formula: see text]-shaped titanium cages (ReBorn Essence Z-Brace cages) and compares the clinical outcomes between [Formula: see text]-shaped titanium cages (ZTC group) and polyetheretherketone cages (PEEK cages, PK group) for the application in transforaminal lumbar interbody fusion (TLIF). Methods: A retrospective and case control study with six patients using PEEK cages and four patients using ZTC was conducted. All patients underwent TLIF and had a 3-month follow-up. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) were selected to assess the pain of low back and neurological status. The intervertebral disc height (DH) and segmental angle (SA) were also measured to estimate the radiological changes. At the 3-month follow-up, the fusion and subsidence rates were evaluated. Results: There was no significant difference between the two groups regarding the ODI and VAS scores. At the 3-month follow-up, the subsidence rates were 42% and 0% for the PK and ZTC groups, respectively; the bony fusion rates were 67% and 100% for the PK and ZTC groups, respectively. Conclusion: The study has indicated that both PEEK and [Formula: see text]-shaped titanium cages can be effective options used to treat degenerative disc disease (DDD). Moreover, the higher fusion and lower subsidence rates have revealed that [Formula: see text]-shaped titanium cages may be a better choice compared to PEEK cages for lumbar reconstruction after TLIF.

Long-term functional outcomes of different subtypes of primary congenital glaucoma

2019 ◽  
pp. bjophthalmol-2019-315131 ◽  
Author(s):  
Richard Sher Chaudhary ◽  
Amisha Gupta ◽  
Ajay Sharma ◽  
Shikha Gupta ◽  
Rayees Ahmad Sofi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Congenital Glaucoma ◽  
Cumulative Probability ◽  
Primary Congenital Glaucoma ◽  
Visual Outcomes ◽  
Post Surgery ◽  
Kaplan Meier ◽  
Significant Difference

AimTo analyse long-term visual outcomes across different subtypes of primary congenital glaucoma (PCG).MethodsPatients with PCG with a minimum of 5-year follow-up post surgery were included in the study. Snellen visual acuity recordings taken at their last follow-up were analysed. We evaluated the results using Kaplan-Meier curves to predict the probability of maintaining good vision (as defined by a visual acuity of 6/18 or better) in our patients after 30-year follow-up. The results were also analysed to determine whether there were any differences in the long-term visual acuities with time between the neonatal and infantile PCG. We also analysed the reasons for poor visual outcomes.ResultsWe assessed a cohort of 140 patients with PCG (235 eyes) with an average follow-up of 127±62.8 months (range 60–400 months). Overall, the proportion of eyes with good visual acuity was 89 (37.9%), those with fair visual acuity between 6/60 and 6/18 was 41 (17.4%), and those with poor visual acuity (≤6/60) was 105 (44.7%). We found a significant difference (p=0.047) between neonatal and infantile patients with PCG whereby the neonatal cohort fared worse off in terms of visual morbidity. On Kaplan-Meier analysis, the cumulative probability of survival of a visual acuity of 6/18 or better was more among the infantile PCG in comparison to the neonatal PCG (p=0.039) eyes, and more among the bilateral than the unilateral affected eyes (p=0.029). Amblyopia was the most important cause for poor visual acuity as shown on a Cox proportional-hazards regression model .ConclusionsLong-term visual outcomes of infantile are better than neonatal PCG. Eyes with unilateral have worse visual outcomes compared with those with bilateral PCG because of the development of dense amblyopia.

scholarly journals Comparison of the efficacy of MIS-TLIF combined with unilateral or bilateral internal fixation on single-segment lumbar degenerative diseases

2019 ◽  
Vol 17 ◽  
pp. 205873921984439
Author(s):  
Lisheng Zhao ◽  
Huijin Yu ◽  
Yan Zhang ◽  
Wenjun Zhen
Keyword(s):  
Internal Fixation ◽  
Lumbar Lordosis ◽  
Clinical Effects ◽  
Degenerative Diseases ◽  
Single Segment ◽  
Tnf Α ◽  
Significant Difference ◽  
Lumbar Degenerative Diseases ◽  
Serum Crp

In this study, to compare the efficacy of minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) combined with unilateral or bilateral internal fixation for the treatment of single-segment lumbar degenerative diseases, patients with single-segment lumbar degenerative diseases treated with MIS-TLIF combined with unilateral or bilateral internal fixation in Rehabilitation Center, Gansu Province Hospital from January 2014 to November 2015 were retrospectively enrolled, and the related data of 85 patients with 2-year follow-up were obtained. The patients were divided into unilateral group (40 cases) and bilateral group (45 cases) according to the method of internal fixation, and the Oswestry dysfunction index (ODI), visual analogue scale (VAS), lumbar lordosis angle, surgical segmental lordosis angle, lumbar scoliosis angle, surgical segmental scoliosis angle, lumbar lordosis index (LI), intervertebral height index (IHI), fusion rates, and serum inflammatory factors, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor alpha (TNF-α), were calculated to evaluate the efficacy of these two surgical methods. The results showed that the VAS and ODI of the two groups at 1 month, 6 months after surgery, and the last follow-up were significantly improved when compared with those before surgery ( P < 0.05). However, there were no significant differences in VAS and ODI between the two groups at preoperative, 1 month, 6 months after surgery, and the last follow-up ( P > 0.05). The lumbar lordosis and LI decreased at 1 month, 6 months, and the last follow-up ( P < 0.05), while the IHI increased when compared with that before surgery ( P < 0.05). Besides, no significant differences were observed in lumbar lordosis, LI, and IHI between the two groups at preoperative, 1 month, 6 months after surgery, and final follow-up ( P > 0.05). In addition, the fusion rates between these two groups had no significant difference ( P > 0.05). The levels of serum CRP, IL-6, and TNF-α at 12 and 24 h after operation in the two groups were higher than those before operation ( P < 0.05), but there was no significant difference in the levels of serum CRP, IL-6, and TNF-α between the two groups at 12 and 24 h after operation ( P < 0.05). In addition, none of the patients of both groups had permanent nerve injury, incision infection, and other complications. These results showed that MIS-TLIF combined with unilateral or bilateral percutaneous internal fixation technique causes less damage to the body tissues of patients with single-segment lumbar degenerative diseases, and they were considered to have similar clinical effects and imaging.

WM1-4 Decompressive craniectomy versus strokectomy for malignant middle cerebral artery (MCA) infarction

2019 ◽  
Vol 90 (3) ◽  
pp. e1.2-e1
Author(s):  
S Moughal ◽  
D Boeris ◽  
A Hainsworth ◽  
E Pereira ◽  
A Shtaya ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Decompressive Craniectomy ◽  
Modified Rankin Scale ◽  
Poor Outcome ◽  
Post Surgery ◽  
Significant Difference ◽  
Malignant Mca Infarction ◽  
Group Post

ObjectivesTo compare the outcomes of decompressive craniectomy (DC) with craniotomy and debulikng of stroke tissue (Strokectomy (SC)) for malignant MCA infarction at our centre.DesignRetrospective records review.SubjectsAll Patients with malignant MCA infraction that underwent DC and SC between Jan 2012 and Sep 2017.Methods20 patients had DC (11F/9M, mean age 44.7±1.8 y) and four patients had SC (1F/3M) 51.5±5.9 7 y). Outcomes were assessed by Modified Rankin Scale (mRS) scores before surgery and at latest follow up (3–6 months). mRS was dichotomised as good (0–3) and poor (4–6). Craniotomy size was measured by antero-posterior (AP) diameter and compared between the groups.Results18 patients (90%) of the DC group had mRS 4–6 before surgery versus 100% in the SC group. Post-surgery 15 patients (75%) of the DC group had poor outcome with 7 mortalities (35%) in comparison to one patient (25%) with poor outcome in the SC group and no mortalities. The average craniotomy size in DC was 120.1±4.1 mm versus 85.5±13.1 mm in the SC, p=0.003 students t test). Six patients of the DC group underwent cranioplasty where two developed post-operative seizures. There was no significant difference in age, sex and side of craniotomy (7 Left/13 Right in DC vs 2 Left/2 Right in SC).ConclusionsStrokectomy is comparable to decompressive craniectomy in outcomes without taking the extra risks and costs of cranioplasty. Further studies are required to promote this approach.

scholarly journals A new expansive two-open-doors laminoplasty for multilevel cervical spondylotic myelopathy: technical report and follow-up results

2014 ◽  
Vol 72 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Aluizio Augusto Arantes Júnior ◽  
Geraldo Alves da Silva Junior ◽  
José Augusto Malheiros ◽  
Fernando Flavio Gonçalves ◽  
Marcelo Magaldi ◽  
...  
Keyword(s):  
Cervical Spondylotic Myelopathy ◽  
Radiographic Evaluation ◽  
Follow Up Study ◽  
Post Surgery ◽  
Technical Report ◽  
Significant Difference ◽  
The Mean ◽  
Clinical And Radiological Results ◽  
Multilevel Cervical Spondylotic Myelopathy

The laminoplasty technique was devised by Hirabayashi in 1978 for patients diagnosed with multilevel cervical spondylotic myelopathy. Objective: To describe an easy modification of Hirabayashi’s method and present the clinical and radiological results from a five-year follow-up study. Method and Results: Eighty patients had 5 levels of decompression (C3-C7), 3 patients had 6 levels of decompression (C2-T1) and 3 patients had 4 levels of decompression (C3-C6). Foraminotomies were performed in 23 cases (27%). Following Nurick`s scale, 76 patients (88%) improved, 9 (11%) had the same Nurick grade, and one patient worsened and was advised to undergo another surgical procedure. No deaths were observed. The mean surgery time was 122 min. Radiographic evaluation showed an increase in the mean sagittal diameter from 11.2 mm at pretreatment to 17.3 mm post surgery. There was no significant difference between pretreatment and post-surgery C2-C7 angles. Conclusions: This two-open-doors laminoplasty technique is safe, easy and effective and can be used as an alternative treatment for cases of multilevel cervical spondylotic myelopathy without instability.

A COMPARISON OF SILICONE REPLACEMENT AND TENDON ARTHROPLASTY FOR BASAL THUMB ARTHRITIS

Hand Surgery ◽  
1998 ◽  
Vol 03 (02) ◽  
pp. 271-276
Author(s):  
W. J. Cumming ◽  
G. A. Parker
Keyword(s):  
Elderly Patients ◽  
Joint Replacement ◽  
Retrospective Review ◽  
Carpometacarpal Joint ◽  
Replacement Arthroplasty ◽  
Significant Difference ◽  
First Carpometacarpal Joint ◽  
Joint Arthritis ◽  
Thumb Arthritis

This paper presents a retrospective review of 39 patients having 52 procedures for first carpometacarpal joint arthritis. Swanson silicone replacement arthroplasty is compared with tendon suspension arthroplasty. There were 34 silicone replacement arthroplasties with an average follow-up of 8.9 years, and 18 suspension arthroplasties with an average follow-up of 6.1 years. There was no statistically significant difference between the two groups. We continue to use silicone for first carpometacarpal joint replacement in elderly patients with low demands.

scholarly journals Comparison of outcomes of ORIF versus bidirectional tractor and arthroscopically assisted CRIF in the treatment of lateral tibial plateau fractures: a retrospective cohort study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangtian Deng ◽  
Hongzhi Hu ◽  
Yiran Zhang ◽  
Weijian Liu ◽  
Qingcheng Song ◽  
...  
Keyword(s):  
Cohort Study ◽  
Internal Fixation ◽  
Clinical Outcomes ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tibial Plateau ◽  
Clinical Score ◽  
Lateral Tibial Plateau ◽  
Significant Difference

Abstract Background Lateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between CRIF and ORIF procedures. Methods We performed a retrospective cohort study of 55 lateral TPF patients (Schatzker types I–III) who accepted surgical treatment at our trauma level 1 center between January 2016 and January 2018. They were divided into the CRIF group (32 patients) and the ORIF group (23 patients) based upon the different surgical protocols. The patients’ clinical outcome analysis was evaluated by using the Knee Society Score (KSS) and Rasmussen’s clinical score. For radiological assessment, changes in tibial plateau width (TPW), articular depression depth (ADD), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) were evaluated using radiographs and computed tomography (CT) scan. Results The CRIF group had a mean follow-up of 28.9 months, and the ORIF group had a mean follow-up of 30.7 months (p>0.05). Furthermore, there was no statistically significant difference in terms of age, gender, injury mechanism, follow-up time, time interval from injury to surgery, and Schatzker classification in the two groups. With respect to the clinical outcomes including the KSS score and Rasmussen’s clinical score, there was also no significant difference (p>0.05). Nevertheless, the CRIF group had lower intra-operative blood loss, shorter hospitalization days, and better range of movement of the knee joint than the ORIF group (p<0.05). Furthermore, CRIF had better radiological results when compared to the ORIF group using Rasmussen’s radiological score (p<0.05), although no significant difference was observed in TPW, ADD, MPTA, and PTSA between the two groups (p>0.05). Conclusion The present study showed that CRIF could achieve comparable clinical outcomes and better radiological results for treating lateral TPFs as compared with conventional ORIF.

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